A growing number of senators are ignoring President Trump’s demands to try yet again to repeal and replace the Affordable Care Act, while some are pushing a new tactic: block-granting health care to the states.

A new report from The Hill provides a long litany of senators who publicly balked at Trump’s demands, which include abolishing the required 60 votes to enact most legislation. Trump has tweeted that by not getting rid of the filibuster, Republicans “look like fools and are just wasting time.”

But it’s not likely happen, Sen. Jeff Flake (R-Ariz.) told CBS News on Monday.

“I don't want to lurch back and forth every couple of years from one extreme to the other,’ Flake said. “Those rules are there for a reason. They're good. ... They invite us to work across the aisle.”

Instead, before leaving town, the GOP Senate leadership plans to focus the next several weeks on getting through the backlog of nominations, as well as approving Christopher Wray’s nomination as FBI director, according to The Hill.

But some senators, including Sen. Lindsey Graham (R-SC) and Sen. Bill Cassidy (R-LA), want to try another health care reform alternative: block-granting health care to the states.

“How about this idea: Instead of trying to re-do Obamacare in Washington, why don’t you turn to the governors,” Graham said on Fox & Friends Tuesday. “Take all the money you would spend in Washington on health care, block grant it back to the states and let them design health care systems closer to your family.”

However, Think Progress contends that block-granting health care to the states would likely leave millions of people uninsured.

“Graham’s plan would also do away with the individual and employer mandates, which ensure that that healthy people stay in insurance pools,” Think Progress reporter Addy Baird writes. “Without the mandate, insurance pools will have a higher ratio of sick to poor people, which will result in higher premiums and could lead to a death spiral.”

The Graham-Cassidy bill does not have a Congressional Budget Office score or the support of 50 senators, according to Politico. But there are increasing talks of bipartisan efforts to stabilize insurance markets and possibly enact other improvements to the ACA. Bipartisan legislation could also force the Trump administration to continue to make cost-sharing reduction payments to insurers, which offset health insurance subsidies for low-income people.

“It’s a constant battle. Health care is one of the most difficult things,” says Sen. Orrin Hatch (R-Utah). “It has to come back before the end of the year. We have to face it.”

When asked if he’s referring to another party-line repeal effort, Hatch replies, “Oh, I hope it’ll be bipartisan.”

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Katie Kuehner-Hebert

Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.